BRETTNEY DAUGHERTY (NPI# 1831554682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831554682 |
| Entity Type | Individual |
| Full Name | BRETTNEY DAUGHERTY |
| Credential | N.P., D.N.P. |
| Practice Address |
1711 Ocean Park Blvd Santa Monica CA 90405-4901 |
| Mailing Address |
648 Sunfish Way Port Hueneme CA 93041-3504 |
| Practice Telephone | 3104502191 |
| Mailing Telephone | 6617473788 |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2019-10-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
95003505 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1711 OCEAN PARK BLVD |
| City | SANTA MONICA |
| State | CA |
| Zip Code | 90405-4901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497722797 | Positron Kebebew | Family Medicine | 1711 Ocean Park Blvd, Santa Monica, CA 90405-4901 | 2006-03-06 |
| 1104379692 | Susan Cho | Registered Nurse | 1711 Ocean Park Blvd, Santa Monica, CA 90405-4901 | 2016-08-01 |
| 1700160421 | Lisa Rebecca Miller | Nurse Practitioner | 1711 Ocean Park Blvd, Santa Monica, CA 90405-4901 | 2011-09-29 |
| 1275851784 | Jenna Tarkela | Nurse Practitioner | 1711 Ocean Park Blvd, Santa Monica, CA 90405-4901 | 2010-05-07 |
| 1407002777 | Rebecca Lynn Rodriguez | Internal Medicine | 1711 Ocean Park Blvd, Santa Monica, CA 90405-4901 | 2008-08-18 |
| 1699938571 | Cesar L Barba | Family Medicine | 1711 Ocean Park Blvd, Santa Monica, CA 90405-4901 | 2008-07-09 |
| 1356526495 | Lee Chaidez Mancilla | Physician Assistant | 1711 Ocean Park Blvd, Santa Monica, CA 90405-4901 | 2008-01-08 |
| 1104012921 | Fantaye Merid | Family Medicine | 1711 Ocean Park Blvd, Santa Monica, CA 90405 | 2007-09-16 |
| 1912045022 | Angelina Yoon Snyder | Physician Assistant | 1711 Ocean Park Blvd, Santa Monica, CA 90405-4901 | 2007-02-01 |
| 1265570576 | Patricia Catherine Chatfield | Nurse Practitioner | 1711 Ocean Park Blvd, Santa Monica, CA 90405-4901 | 2007-02-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699328476 | Nicole Ryan Harbeck | Marriage & Family Therapist | 2716 Ocean Park Blvd Ste 2007, Santa Monica, CA 90405 | 2019-07-19 |
| 1922664440 | Betty Ann Wise | Counselor | 1865 W. 9th Street, Santa Monica, CA 90405 | 2019-05-10 |
| 1790203776 | Ernest Jones Jr. | Counselor | 909 Pico Blvd., Santa Monica, CA 90405 | 2017-08-30 |
| 1285171371 | Jori Adler Marriage & Family Therapy Prof. Corp. | Marriage & Family Therapist | 3400 Airport Ave Ste 30, Santa Monica, CA 90405 | 2017-01-26 |
| 1376993147 | Damoan Corp. | Speech-Language Pathologist | 2801 Ocean Park Blvd Ste 393, Santa Monica, CA 90405 | 2016-06-13 |
| 1427410034 | Adam Rubio | Clinical Neuropsychologist | 1916 4th Street, Santa Monica, CA 90405 | 2016-03-23 |
| 1760852842 | Yramnna Smith | Behavioral Analyst | 2716 Ocean Park Blvd Ste 1025, Santa Monica, CA 90405 | 2015-10-01 |
| 1689086076 | Cheryl K. Baker | Community Health Worker | 1750 Ocean Park Blvd., Suite 206, Santa Monica, CA 90405 | 2014-05-20 |
| 1629409891 | Dominique M. Delvecchio | Nurse Practitioner | 2716 Ocean Park Blvd. Suite 3082, Institute for Nerve Medicine, Santa Monica, CA 90405 | 2013-12-12 |
| 1639512692 | Nancy Elizabeth Hyland | Marriage & Family Therapist | 1720 Ocean Park Blvd, Suite 200a, Santa Monica, CA 90405 | 2013-04-09 |
| Find all providers in zip 90405 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376071472 | Charmaine Bade | Nurse Practitioner | 1223 23rd St Apt A, Santa Monica, CA 90404-1323 | 2017-06-01 |
| 1275059131 | Ana Maricela Rocha | Nurse Practitioner | 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 | 2017-08-22 |
| 1306053038 | Amy Michelle Taylor Serafini | Nurse Practitioner | 2001 Santa Monica Blvd, Suite 360w, Santa Monica, CA 90404 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235738782 | Peninsula Healthcare Center | Nurse Practitioner | 22330 Hawthorne Blvd Ste 208, Torrance, CA 90505-2536 | 2020-10-25 |
| 1710584008 | Venessa Beck | Nurse Practitioner | 903 Cardiff St, San Diego, CA 92114-5019 | 2020-10-08 |
| 1053918094 | Janel Nicole Sanglerat | Nurse Practitioner | 416 Aviation Blvd, Santa Rosa, CA 95403-1032 | 2020-10-02 |
| 1790382760 | Christopher Tran | Nurse Practitioner | 11441 Heacock St Ste F, Moreno Valley, CA 92557-7907 | 2020-10-02 |
| 1487266292 | Mollie Shira Hudson | Nurse Practitioner | 14 Whitmore Pl Apt 15, Oakland, CA 94611-4635 | 2020-08-21 |
| 1962014381 | Mario Javier Herrera | Nurse Practitioner | 2130 High Pointe Dr, Apt 108, Corona, CA 92879 | 2020-08-18 |
| 1952912131 | Norman Ivan Kier | Nurse Practitioner | 3834 Edison Ave, Sacramento, CA 95821-2728 | 2020-08-12 |
| 1942811377 | Thanhan Mathews | Nurse Practitioner | 114 W Cameron St Apt B, Hanford, CA 93230-2965 | 2020-08-10 |
| 1972113355 | Marine Mary Kademyan | Nurse Practitioner | 6528 Babcock Ave, North Hollywood, CA 91606 | 2020-07-31 |
| 1245849645 | Shannon Pereira | Nurse Practitioner | 2368 Honeysuckle Way, Hemet, CA 92545-4796 | 2020-07-31 |
| Find all providers with the same taxonomy | ||||
| City | SANTA MONICA |
| Zip Code | 90405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.